Paediatric Cardiology, Department of Paediatrics, Tampere University Hospital, Tampere, Finland.
Tampere Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Eur J Pediatr. 2023 Mar;182(3):1089-1097. doi: 10.1007/s00431-022-04757-5. Epub 2022 Dec 28.
Antiarrhythmic medication (AM) is commonly used to prevent supraventricular tachycardia (SVT) recurrence in infants. Our aim was to determine whether a shorter duration of AM is sufficient to prevent atrioventricular reentrant tachycardia (AVRT) recurrence and evaluate risk factors for recurrence of SVT after discontinued AM.This multicenter cohort study included all infants diagnosed with SVT in the five university hospitals in Finland between 2005 and 2017. Those diagnosed between 2005 and 2012 received AM for 12 months (group 1), and those diagnosed between 2013 and 2017 received AM for 6 months (group 2). A total of 278 infants presented with AVRT (group 1, n = 181; group 2, n = 97), and the median AM duration was 12.0 months (interquartile range [IQR] 11.4-13.4) and 7.0 months (IQR 6.0-10.2), respectively. Propranolol was the most frequently used first-line AM (92% and 95%). Recurrence-free survival rates were over 88% until 12 months after AM prophylaxis in both groups, without any statistically significant difference between them. Independent risk factors for recurrence of SVT after discontinuation of AM were need of combination AM (HR 2.2, 95% CI 1.14-4.20), Wolff-Parkinson-White (WPW) syndrome (HR 2.4, 95% CI 1.25-4.59), and age over 1 month at admission (HR 2.2, 95% CI 1.12-4.48). Conclusion: Shortening AM duration in infants from 12 to 6 months does not seem to lead to more frequent SVT recurrence. The risk factors for recurrence of SVT were WPW syndrome, need of combination AM, and age over 1 month.
抗心律失常药物（AM）常用于预防婴儿的室上性心动过速（SVT）复发。我们的目的是确定 AM 的较短持续时间是否足以预防房室折返性心动过速（AVRT）的复发，并评估 AM 停药后 SVT 复发的危险因素。
这项多中心队列研究包括 2005 年至 2017 年期间在芬兰的五所大学医院诊断为 SVT 的所有婴儿。2005 年至 2012 年间诊断出的婴儿接受 AM 治疗 12 个月（组 1），2013 年至 2017 年间诊断出的婴儿接受 AM 治疗 6 个月（组 2）。共有 278 名婴儿出现 AVRT（组 1，n=181；组 2，n=97），AM 的中位持续时间分别为 12.0 个月（四分位间距 [IQR] 11.4-13.4）和 7.0 个月（IQR 6.0-10.2）。普萘洛尔是最常使用的一线 AM（92%和 95%）。在两组中，AM 预防治疗后 12 个月内，无复发生存率均超过 88%，且两组之间无统计学差异。AM 停药后 SVT 复发的独立危险因素包括需要联合 AM（HR 2.2，95%CI 1.14-4.20）、WPW 综合征（HR 2.4，95%CI 1.25-4.59）和入院时年龄超过 1 个月（HR 2.2，95%CI 1.12-4.48）。
将婴儿的 AM 持续时间从 12 个月缩短至 6 个月似乎不会导致 SVT 复发更频繁。SVT 复发的危险因素是 WPW 综合征、需要联合 AM 和入院时年龄超过 1 个月。
